Perioperative and Postoperative Complications Associated with Stapled Hemorrhoidopexy

Stapled hemorrhoidopexy (SH) has been proposed as a less invasive alternative to open hemorrhoidectomy (OH) for advanced hemorrhoidal disease. This study compared perioperative and short-term postoperative outcomes between SH and OH in a Bangladeshi population. A prospective comparative study was conducted among 130 patients (65 per group) with Grade III and IV hemorrhoids. Baseline characteristics, perioperative blood loss, postoperative pain (VAS), complications, hospital stay, return to work and treatment cost were analyzed using appropriate statistical tests. Baseline age, gender and hemorrhoid grade distributions were comparable between groups (p>0.05). SH was associated with lower postoperative pain (80.0% mild; no severe cases), reduced urinary retention (13.8% vs. 40.0%, p=0.001) and shorter hospital stays (mean 2.89 vs. 7.12 days, p<0.001). Return to work was faster in SH (mean 7.72 vs. 14.29 days, p<0.001). Reactionary hemorrhage occurred only in OH (6.2%, p=0.042). Perioperative blood loss differences were not statistically significant (p=0.149). SH incurred significantly higher costs (mean Tk. 18,876.92 vs. Tk. 6,690.77, p<0.001). SH offers significant short-term clinical benefits over OH, including reduced pain, faster recovery and fewer complications. However, higher costs may limit its feasibility in resource-constrained healthcare systems. Cost-effectiveness evaluation is essential before widespread adoption.